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Application for the 2009 Class of the
Institute for Georgia Environmental Leadership

Application must be received by close of business on Monday, November 3rd, 2008.
Questions or concerns related to your application should be addressed to Sue Hilliard, at 229-254-1903 or sue_igel@bellsouth.net

AGREEMENT

The Institute for Georgia Environmental Leadership consists of four sessions held from May through November 2009:

Session 1 -- May 13-15, 2009
Session 2 -- July 22-24, 2009
Session 3 -- September 16-18, 2009
Session 4 -- November 3-6, 2009

By checking this box, I understand the goals of the Institute for Georgia Environmental Leadership, as well as my commitment of time and resources. If selected, I commit to 100% attendance at all four sessions.  

Contact Information

First Name:
Last Name:
Email Address:
Please use the address you want IGEL information sent to.
Work phone:
Home phone:
Cell:
Fax:

Business Address

This is my preferred mailing address
Address 1:
Address 2:
City:
State:    Zip:
County:

Home Address

This is my preferred mailing address
Address 1:
Address 2:
City:
State:    Zip:
County:

Other Required Info:

Age Range*: 21-40 41-55 Over 55
Gender*: Male Female
Race/Ethnic Origin*:
Asian/Pacific Islander
American Indian/Alaskan Native
Black, not of Hispanic Origin
Hispanic
White, not of Hispanic Origin

I was nominated by:

Other References:
A) B)  

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*This information helps to ensure that the IGEL program appropriately reflects the diversity of Georgia.

Education

Please include Institution Name, Location, Dates Attended, and Degree Earned.

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High School
College(s)
Other  

Employment

Current Employer/Occupation
Employment address:
Dates of employment:
Title and scope of responsibility:  

Employment History (last 10 years):

Employer & Location: Position/Title: Dates: * Please use the format provided. Copy and paste the format for multiple entries. *  

Professional or Volunteer Organizations/Activities:

Please list, in order of importance to you, no more than five organizations or activities in which you have been involved. Organization: Position(s) Held: Dates:  

Open-Ended Questionnaire

Explain, in the space provided, your greatest professional, civic and/or volunteer accomplishments:
What do you believe are the two or three most important environmental issues in Georgia today, and why?
What do you believe are the leadership skills most critical to addressing Georgia’s environmental issues?
What do you hope to achieve from your experience in the IGEL program?  

TUITION, FEES AND EXPENSES

The tuition fee is :
$3600: corporate/for profit
$2850: government/non-profit
If selected, you will receive an invoice for your tuition which will be due by Friday, February 13th, 2009. Tuition covers instruction, materials, lodging and meals for four sessions. Tuition does not cover pre- or post-session lodging. Transportation to and from each session site is the participant's expense.

Who will pay your tuition and other expenses?
Employer Participant Other (please specify)  

PARTIAL FINANCIAL ASSISTANCE

A limited number of need-based partial scholarships are available for selected applicants who cannot otherwise afford to participate. Scholarships are limited to 50% or less of the tuition fee. If you wish to be considered, please indicate the amount you are requesting below and explain your need for assistance in the space provided. Assistance requests and grants are kept confidential.

Requests not accompanied by an explanation will not be considered.

Amount requested: $
Explanation:  

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This page was updated Oct. 09, 2008 at 3:36pm.